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      Are Malaysian Type 2 Diabetes patients willing to be trained to speak to their offspring about risk of diabetes and preventive measures?

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          Abstract

          Background

          Offspring of type 2 diabetes patients have an absolute risk of 20–40% of developing the condition. Type 2 diabetes patients should be encouraged to speak to their offspring regarding diabetes risk and prevention strategies. The Health Belief Model conceptualises that the higher the perceived risk, the more likely an individual will modify their behaviour. The objectives of this study were to i) determine the distribution of type 2 diabetes patients regarding their willingness to accept training to speak to their offspring, ii) determine the distribution of type 2 diabetes patients regarding their willingness to accept training based on the HBM and iii) to determine the factors associated with their willingness to accept training.

          Methods

          This was a cross-sectional study amongst type 2 diabetes patients attending two primary care clinics in Malaysia. Sociodemographic data and knowledge of diabetes risk factors were collected. The adapted, translated and validated Diabetes Mellitus in the Offspring Questionnaire-Malay version (DMOQ-Malay) was self-administered. Statistical analysis included descriptive statistics, univariate and multiple logistic regression (MLogR).

          Results

          A total of 425 participants were recruited. Of these, 61.6% were willing to accept training. In MLogR, six variables were found to be significantly associated with willingness to accept training. These were i) positive family history [Adj. OR 2.06 (95% CI: 1.27, 3.35)], ii) having the correct knowledge that being overweight is a risk factor [Adj. OR 1.49 (95%CI: 1.01, 2.29)], iii) correctly identifying age ≥ 40 years old as a risk factor [Adj. OR 1.88 (95%CI: 1.22, 2.90)], iv) agreeing that speaking to their offspring would help them to prevent type 2 diabetes [Adj. OR 4.34 (95%: 1.07, 17.73)], v) being neutral with the statement ‘I do not have much contact with my offspring’ [Adj. OR: 0.31 (95% CI: 0.12, 0.810] and vi) being neutral with the statement ‘my offspring are not open to advice from me’ [Adj. OR: 0.63 (95% CI: 0.31, 0.84].

          Conclusion

          The majority of type 2 diabetes patients were willing to accept training to speak to their offspring to prevent diabetes. A training module should be designed to enhance their knowledge, attitude and skills to become family health educators.

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          Most cited references16

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          Testing four competing theories of health-protective behavior.

          Four competing theories of health-protective behavior are reviewed: the health belief model, the theory of reasoned action, protection motivation theory, and subjective expected utility theory. In spite of their commonalities, these models are seldom tested against one another. The review points out the similarities and differences among these theories and the data and analyses needed to compare them. In addition to describing the content of the models, their conceptualization of key variables, and the combinatorial rules used to make predictions, some general problems in theory development and testing for health behaviors are examined. The article's goal is to help investigators design studies that will clarify the strengths and weaknesses of these models, leading toward a better understanding of health behavior.
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            Family history of diabetes as a potential public health tool.

            Given the substantial morbidity and mortality associated with type 2 diabetes, it is important that public health seek ways to delay or prevent the onset of this condition. Risk factors for type 2 diabetes are well established and include underlying genetic susceptibility. Despite this knowledge, as well as significant advances in understanding the human genome, the prevalence of type 2 diabetes continues to rise at an alarming rate. Because type 2 diabetes is a complex condition involving a combination of genetic and environmental factors, DNA testing for susceptibility genes is not yet warranted. However, because family history reflects genetic susceptibility in addition to other factors, it may be a useful public health tool for disease prevention. When evaluating family history as a public health tool, several important issues need to be considered, including the analytic and clinical validity and the clinical utility of using family history as a screening tool. These issues as well as a review of the epidemiologic evidence evaluating family history as a risk factor will be reviewed.Overall, a family history approach appears to be a promising new public health tool to fight the growing epidemic of diabetes in the United States. Adequate levels of funding to further evaluate this approach and to develop appropriate tools should be made available for research activities focused on this important area.
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              Family lifestyle and parental body mass index as predictors of body mass index in Australian children: a longitudinal study.

              To investigate associations between body mass index (BMI) and family characteristics, including lifestyle, in parents and offspring from Australian families. Longitudinal survey of 219 families of Australian children who had been surveyed 3-yearly between the ages of 9 and 18 y. Socio-economic status, weight and height, diet from 3 day records or food frequency questionnaires, alcohol consumption, smoking habits and physical fitness in offspring (bicycle ergometry in 18-y-olds). In 18-y-olds, in models examining offspring's lifestyle variables, BMI was predicted negatively by physical fitness (P=0.012), and positively by alcohol intake (P=0.046) in sons while, in daughters, only a negative association with physical fitness was significant. In models including parental characteristics, BMI in 18-y-old sons and daughters was significantly predicted by mothers' and fathers' BMI, independently of offsprings' alcohol intake, smoking, physical fitness and parents' education, and, in daughters, by fathers' alcohol intake. These models explained 48% of variance in daughters and 33% in sons. In both sons and daughters, BMI over the 9 y of the survey was consistently higher in offspring with overweight or obese fathers (P=0.033 for sons, P=0.024 for daughters) or mothers (P=0.031 for sons, P=0.037 for daughters). Physical fitness at the ages of 12, 15 and 18 y was negatively related to fathers' obesity in daughters and mothers' obesity in sons. Obesity in fathers was associated with a four-fold increase in risk of obesity at the age of 18 y in both sons and daughters with an independent eight-fold increase in risk for daughters if mothers were obese. Birthweight was unrelated to overweight or obesity in the 18-y-olds. Alcohol intake in sons related significantly to alcohol intake in either parent while, for daughters, there was a significant association only with fathers' alcohol consumption. In daughters, fat intake was positively associated with fat intake score in both fathers and mothers. Parental overweight or obesity may identify children at risk for a range of unhealthy behaviours. Promotion of a healthy lifestyle targeting overweight families, particularly in lower socio-economic groups, should be a priority.
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                Author and article information

                Contributors
                fatimabadli@gmail.com
                rossanis_yuzadi@yahoo.co.uk
                rodi@uitm.edu.my
                zakiah_zaki7691@yahoo.com
                david@rcsiucd.edu.my
                Journal
                BMC Fam Pract
                BMC Fam Pract
                BMC Family Practice
                BioMed Central (London )
                1471-2296
                11 March 2020
                11 March 2020
                2020
                : 21
                : 50
                Affiliations
                [1 ]GRID grid.412259.9, ISNI 0000 0001 2161 1343, Department of Primary Care Medicine, Faculty of Medicine, , Universiti Teknologi MARA (UiTM), ; Selayang Campus, Jalan Prima Selayang 7, 68100 Batu Caves, Selangor Malaysia
                [2 ]GRID grid.412259.9, ISNI 0000 0001 2161 1343, Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), , Universiti Teknologi MARA (UiTM), ; Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor Malaysia
                [3 ]GRID grid.412259.9, ISNI 0000 0001 2161 1343, Department of Public Health Medicine, Faculty of Medicine, , Universiti Teknologi MARA, ; Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor Malaysia
                [4 ]Department of Medicine, Hospital Kuala Lumpur, Ministry of Health, Jalan Pahang, 50586 Wilayah Persekutuan Kuala Lumpur, Malaysia
                [5 ]RCSI & UCD Malaysia Campus, 4, Jalan Sepoy Lines, 10450 George Town, Pulau Pinang Malaysia
                Article
                1121
                10.1186/s12875-020-01121-0
                7066836
                32160862
                816cbcee-fd38-4507-8b9e-357a7d6c07fe
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 2 July 2019
                : 3 March 2020
                Funding
                Funded by: Ministry of Education Malaysia
                Award ID: 600-RMI/RAGS 5/3 (78/2014)
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Medicine
                diabetes mellitus,offspring,risk perception,training,primary care,malaysia
                Medicine
                diabetes mellitus, offspring, risk perception, training, primary care, malaysia

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